Individual
DR. JESSE WADE MCINTYRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DAT, LAT, ATC, CSCS
Contact information
Practice address
210 LA SALLE DR, SAN ANGELO, TX 76903-7916
(405) 614-2024
Mailing address
210 LA SALLE DR, SAN ANGELO, TX 76903-7916
(405) 614-2024
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT003021
GA
2255A2300X
Athletic Trainer
Primary
AT7626
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT003021
ATHLETIC TRAINER CERTIFIED AND LICENSED
GA
01
—
AT7626
TDLR
TX
Enumeration date
10/01/2017
Last updated
03/23/2026
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